If there’s an upshot to Barry Estabrook’s must-read piece on the critical failings of the Food and Drug Administration (FDA) — the agency charged with keeping most of our food safe — it’s this: Be afraid. Be very afraid.

And no, I’m not exaggerating. As Estabrook reports, we’re in the midst of a food poisoning epidemic. “According to the CDC, there are about 48 million cases of food poisoning a year, leading to more than 128,000 hospitalizations and more than 3,000 deaths,” he writes.

To put that last statistic in perspective, it’s the equivalent of a 9/11 tragedy every year. You’d think the government (and the American people) might want to do something to stop it.

Now, it’s true that not all deaths from food poisoning can be prevented by government action. But as Estabrook explains, the FDA isn’t doing nearly enough to get that number down. He sums up the agency’s shortcomings like this:

In report after report, the Government Accountability Office (GAO), the investigative arm of Congress, has uncovered woeful shortcomings at the agency. Its product recall process is ineffective and confusing. It has done a poor job of dealing with the overuse of antibiotics in livestock feed. It lacks the scientific capacity to perform its duties. Even when it does uncover health violations at food-processing plants, the FDA takes enforcement action in only about half of the cases and almost never imposes fines. In the coldhearted calculus of turning a profit, it is perversely logical for corporations to risk making hundreds of people ill when the worst they can expect is a warning letter.

“It’s like doing 100 miles an hour on a lonely stretch of highway in Montana,” says William Marler, a Seattle-based attorney who has represented food-poisoning victims in court for 20 years. “Yeah, you might get caught, but in reality the chances of that happening are zero.”

Estabrook points to last year’s case of salmonella-contaminted cantaloupe in Colorado, the 2010 case of salmonella-contaminated eggs from Iowa, and the infamous salmonella-contaminated peanut butter episode from 2009 as case studies in FDA failure. All of those outbreaks, which led to illnesses and — in the cases of the cantaloupe and peanut butter incidents — deaths, originated from single farms or facilities but had effects nationwide. What else did they have in common? None of the facilities were visited by FDA inspectors until after the outbreaks. Why? The answer comes down to pure numbers:

[T]he FDA is being slowly starved of the resources and manpower required to fulfill its mandate. In the 1970s the agency conducted 35,000 inspections of food-processing plants each year. Today, it inspects fewer than 8,000, although the number of facilities under its jurisdiction has skyrocketed.

… The FDA employs about 1,000 food inspectors, who have to cover 421,000 registered production facilities. The Department of Agriculture, by comparison, has about 7,000 inspectors for about 7,000 facilities. A USDA inspector is present at every operating slaughterhouse or poultry processor.

The FDA’s ratio of facilities to inspectors is more than a little off. And you get what you pay for. If we want safe food we need to spend more. A lot more. Food safety lawyer Bill Marler told Estabrook he thought that properly protecting our food would cost $10 billion per year, compared to the $1.4 billion the agency plans to spend.

We have a maddeningly complex food system. It involves ingredients grown or manufactured in facilities across the nation and the world, which are then combined in other factories and distributed far and wide. We need a food safety agency with the staff and power to match. And we simply don’t have it.

Of course, food contaminated by pathogens is only part of problem. There’s also the minor issue of the thousands of chemicals and additives the FDA allows companies to put in our food with little or no safety testing. This is all thanks to the agency’s “Generally Regarded as Safe” (GRAS) list of food additives, the shortcomings of which I wrote about during the “pink slime” debate.

The GRAS protocol was originally designed to allow easy use of things like salt, pepper, and spices. But now, companies need only find an “expert” who will declare an additive “safe for consumption” before they can put it in food. The company needn’t even inform the FDA of exactly what the additive is, because, you know, it’s “proprietary information”! It also means we don’t have a complete idea of what’s going into our bodies.

Estabrook invoked a 2010 GAO report that slammed the GRAS list as terrible policy, and not just because it encourages companies to withhold information. The GAO report observed that GRAS also makes it:

“difficult, if not impossible” to trace a specific food safety problem to a specific ingredient. If the agency cracks down too hard and issues too many rejections, companies might not bother to notify the government at all, leaving it — and the public it is supposed to protect — “in the dark.”

“In the dark” is exactly where food processing companies, and even some industrial farmers, want Americans to stay. The FDA is overpowered time and time again by an industry trying to keep prying eyes away from what it’s got cooking.

And the food industry isn’t likely to stop pushing the envelope any time soon. In fact, it may be gearing up for a further push against regulations in general. For example, North Dakota just added a “right to farm” amendment to its state constitution that declares, “No law shall be enacted which abridges the right of farmers and ranchers to employ agricultural technology, modern livestock production and ranching practices.”

And while these farming “protections” are aimed mostly at stopping animal welfare laws and GMO restrictions, which fall mostly under the jurisdiction of the USDA, it’s also true that experts aren’t quite sure what the amendment’s full implications will be. Should it stand up to court challenge — a big “if” — it could also shield factory farms and large producers from food safety regulations. According to this report from the AP, it’s also viewed as a model amendment which anti-regulation advocates will attempt to pass in other states.

The good news in the midst of this mess, if there is any, is that the recently passed federal food safety reform law gave the FDA new powers. And the agency just used them in shutting down another contaminated peanut butter operation — in the past, it was restricted to meting out fines and sending warning letters. Of course, once again the FDA didn’t act until after people got sick.